Adherence with prostate cancer screening (such as PSA tests, and physician follow-ups), is less than perfect. In large part, this is because members of at-risk populations need to keep track of which tests are required and at what time. As screening guidelines and timetables become more personalized (e.g. different recommendations for follow-up intervals depending on past history of PSA levels), such problems are likely to be exacerbated. Yet, there is a great deal of evidence that early screening and detection are key to better prognoses, lower mortality rates, and lower health-care expenditures. We propose to increase compliance with cancer screening, using prostate cancer as an example, through two-way rich media mobile messaging based on the personalized risk assessment. The product we propose to develop and test will store algorithms required to personalize cancer screening in a central database managed by a rule-based workflow engine, and implemented via messaging on the patient's own mobile phone. Participants will receive a mobile message on the appropriate date stating that it is time for them to schedule and prostate cancer screening appointment with their doctor. Reminder messages will incorporate multimedia, such as a brief video interview with an expert, to reinforce the importance of screening. Participants will be asked to report the results of tests (for example PSA levels), by replying to the message on their mobile phone or by visiting a portal web site. The project will be piloted in a large rural hospital system providing primary and preventive care services, and be evaluated based on a randomized controlled efficacy trial, as well as pre- and post- measures of participant acceptance and engagement. If successful, phase II SBIR funding will be utilized to conduct a longitudinal trial to understand long term efficacy of the messaging intervention, and to develop and deliver messages relevant to screening for other types of cancer. PUBLIC HEALTH RELEVANCE: We propose to build a technology solution that provides personalized cancer screening reminders via two-way rich media mobile messaging solutions. The solution personalizes each patient's screening schedule based on personal profile and past screening results, and use consumer mobile technology to engage patients. Such interactive reminders could provide a low cost solution for increasing adherence to cancer screening, and help differentiating patients that are at high risk of non-adherence for more aggressive follow-ups.